Pyloric Resection and Delayed Gastric Liquid Emptying in Rats

You, Chengzhong; Dong, Rong; Sun, Jin-Hua; Xiao, Jiaquan; Qu, Huamin; Du, Miaomiao; Huang, Hai-Quan; Tang, Wen-hao

doi:10.1007/s10620-010-1238-x

Cited by 2 publications

(2 citation statements)

References 43 publications

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“…surgery normal propagation was usually restored, indicating that conduction pathways had effectively re-established across healing gastric suture lines. 51 It has now been confirmed that this recovery of conduction is due to ICC regeneration and bridging within gastric myenteric layers across healing scar, 20,56 thereby providing an additional layer of resilience to surgical manipulation.…”

Section: Homeostatic Conduction Anisotropymentioning

confidence: 93%

“…A number of animal studies have also identified the GAP including in canines post-Billroth I, 71 canines post-Whipple, 72 and rats post-Billroth I which also demonstrated regeneration of ICC across the anastomotic scar on histology. 56 Other studies utilizing EGG have found that a subset of patients following distal gastrectomy have new bands of high-frequency activity (~7-12 cpm). These studies followed Billroth I, 73 Billroth II, 74 and various other gastric resections.…”

Section: The Pylorus and The Gastrointestinal Aberrant Pathwaymentioning

confidence: 98%

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The Impact and Clinical Implications of Gastric Surgery on the Gastric Conduction System

Carson

Robertson

Wang

et al. 2022

Foregut: The Journal of the American Foregut Society

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Chronic symptoms of gastric dysfunction are common following gastric surgery, but the mechanisms underlying these have remained poorly understood. Disturbances of foregut motility are suspected to play a central role, however knowledge of how these abnormalities manifest and relate to symptoms requires elucidation. Emerging data suggests that abnormalities of the gastric conduction system are a common consequence of gastric surgery and may contribute to dysmotility and post-operative symptoms. This review provides a primer on the gastric conduction system. The normal physiology of the gastric conduction system and factors that influence resilience to surgery are outlined, together with focused discussion on three surgical procedures that impact post-operative gastric dysfunction: resection of the gastric pacemaker, resection or bypass of the pylorus, and vagotomy. The mechanistic pathways that underpin the clinical effects of these procedures are discussed. Future horizons are also evaluated, including newly established body surface gastric mapping techniques that provide a non-invasive method to detect changes in the gastric conduction system and relate these to symptoms in postoperative patients, with the goal of developing targeted interventions for prevention and therapy.

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Section: Homeostatic Conduction Anisotropymentioning

confidence: 93%

Section: The Pylorus and The Gastrointestinal Aberrant Pathwaymentioning

confidence: 98%

The Impact and Clinical Implications of Gastric Surgery on the Gastric Conduction System

Carson

Robertson

Wang

et al. 2022

Foregut: The Journal of the American Foregut Society

View full text Add to dashboard Cite

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Slow-wave coupling across a gastroduodenal anastomosis as a mechanism for postsurgical gastric dysfunction: evidence for a “gastrointestinal aberrant pathway”

Wang

Angeli

Beban

et al. 2019

American Journal of Physiology-Gastrointestinal and Liver Physi

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Postsurgical gastric dysfunction is common, but the mechanisms are varied and poorly understood. The pylorus normally acts as an electrical barrier isolating gastric and intestinal slow waves. In this report, we present an aberrant electrical conduction pathway arising between the stomach and small intestine, following pyloric excision and surgical anastomosis, as a novel disease mechanism. A patient was referred with postsurgical gastroparesis following antrectomy, gastroduodenostomy, and vagotomy for peptic ulceration. Scintigraphy confirmed markedly abnormal 4-h gastric retention. Symptoms included nausea, vomiting, postprandial distress, and reflux. Intraoperative, high-resolution electrical mapping was performed across the anastomosis immediately before revision gastrectomy, and the resected anastomosis underwent immunohistochemistry for interstitial cells of Cajal. Mapping revealed continuous, stable abnormal retrograde slow-wave propagation through the anastomosis, with slow conduction occurring at the scar (4.0 ± 0.1 cycles/min; 2.5 ± 0.6 mm/s; 0.26 ± 0.15 mV). Stable abnormal retrograde propagation continued into the gastric corpus with tachygastria (3.9 ± 0.2 cycles/min; 1.6 ± 0.5 mm/s; 0.19 ± 0.12 mV). Histology confirmed ingrowth of atypical ICC through the scar, defining an aberrant pathway enabling transanastomotic electrical conduction. In conclusion, a “gastrointestinal aberrant pathway” is presented as a novel proposed cause of postsurgical gastric dysfunction. The importance of aberrant anastomotic conduction in acute and long-term surgical recovery warrants further investigation. NEW & NOTEWORTHY High-resolution gastric electrical mapping was performed during revisional surgery in a patient with severe gastric dysfunction following antrectomy and gastroduodenostomy. The results revealed continuous propagation of slow waves from the duodenum to the stomach, through the old anastomotic scar, and resulting in retrograde-propagating tachygastria. Histology showed atypical interstitial cells of Cajal growth through the anastomotic scar. Based on these results, we propose a “gastrointestinal aberrant pathway” as a mechanism for postsurgical gastric dysfunction.

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Pyloric Resection and Delayed Gastric Liquid Emptying in Rats

Abstract: The gastroduodenal incoordination and abnormal myoelectricity related to impaired contraction in the antrum caused the delayed liquid gastric emptying in pylorectomy rats.

Cited by 2 publications

References 43 publications

The Impact and Clinical Implications of Gastric Surgery on the Gastric Conduction System

The Impact and Clinical Implications of Gastric Surgery on the Gastric Conduction System

Slow-wave coupling across a gastroduodenal anastomosis as a mechanism for postsurgical gastric dysfunction: evidence for a “gastrointestinal aberrant pathway”

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